posted on: December 7, 2023
Skin classification systems have been used for centuries and were originally created to implement a social caste system. Social orders were based on wealth, education, political views, and other factors, including skin color.
The Fitzpatrick Scale
The Fitzpatrick Scale was not developed until 1975 by Dr. Thomas Fitzpatrick, chairman of Harvard Medical School, but it has become the trusted gold standard of skin typing.1 The original purpose of the Fitzpatrick Scale was to measure the skin’s ability to tolerate UV light. Doctors would use this scale to estimate a patient’s risk of burning or tanning and as it relates to the amount of melanin produced by the skin. Doctors could then use this information to determine the amount of UV light therapy needed to treat skin disorders like psoriasis and eczema without causing phototoxicity or irritation to the patient.2
The scale is based on a series of questions relating to natural skin, hair, and eye color as well as ethnicity and reaction to unprotected sun exposure. Those with a low Fitzpatrick score and lighter skin tone are more likely to burn and should maintain a low exposure to UV light, while those with a high Fitzpatrick score have more melanin in the skin and are more likely to tan.3 Individuals more. Likely to tan can tolerate more UV light but may experience other sensitivities as a result of sun exposure.
As the skin care industry has advanced, the scale has become a tool to set treatment parameters and predict clients’ melanin response to treatment. Those with a lower Fitzpatrick score and small degree of pigmentation may develop prolonged erythema, while those with a higher Fitzpatrick score and a large degree of pigmentation are at a greater risk of developing post inflammatory pigmentation.
Other Skin Classification Systems
Although the Fitzpatrick Scale is trusted by many, there are other deductive skin typing systems for measuring skin’s reactivity. The Lancer Ancestry Scale was originally developed in 1998 by Dr. Lancer and builds on the Fitzpatrick Scale by including a deeper dive into a client’s ancestry, as Dr. Lancer believed a patient’s appearance could be deceiving. For example, a client with blue eyes, blond hair, and a pale complexion may appear to be an ideal candidate for laser or chemical peels. But closer examination of their heritage may reveal hidden genes for darker pigmentation that could result in damage to their skin if they followed through with that treatment.4
The Glogau Photoaging Scale grades the amount of skin aging from sun exposure found in Caucasian skin.5 This scale can be used as an indicator for expected improvement from treatments with the assumption that a greater degree of damage means less improvement expected. Because of its narrow focus, this scale is not widely adopted.
The Roberts Skin Type Classification system was developed by Dr. Wendy Roberts in 2008. This scale also expands on the Fitzpatrick Scale to predict the skin’s response to injury and inflammation.1 This scale looks at four factors: The Fitzpatrick Scale classification, the Glogau Scale ranking, the tendency for hyperpigmentation, and the tendency for scarring.
Looking for more great content on skin classification systems?
ASCP's Esty Talk episode 162, Beyond Fitzpatrick Typing, explores skin phototyping beyond just the basic (and potentially antiquated) Fitzpatrick Scale.
Check out ASCP Esty Talk or subscribe to the podcast in the Apple Podcast Store, Google Podcasts, Spotify, YouTube, or wherever you access your favorite podcasts.
NOTES
1. Nielsen, Mary. 2020. Fearless Beauties. Portland: Skintelligent Resources.
2. Healthline. "About the Fitzpatrick Skin Types." Accessed July 31 2023. https://www.healthline.com/health/beauty-skin-care/fitzpatrick-skin-type...
3. NewBeauty. "How to Use the Fitzpatrick Scale." Accessed July 31 2023. https://www.newbeauty.com/how-to-use-fitzpatrick-scale/.
4. Lancer Skincare. "The Lancer Ancestry Scale: Diving Deeper." Accessed July 31 2023. https://www.lancerskincare.com/blog/the-lancer-ancestry-scale-diving-dee...
5. San Francisco Dermatology. "Glogau Wrinkle Scale." Accessed July 31 2023. https://sfderm.com/glogau-wrinkle-scale/.
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